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'Survivor' program evolves, inspires broader audience
Focus is on audience participation
A "Survivor" leadership and team-building program developed at Mt. Graham Regional Medical Center is prompting "aha moments" among an increasing circle of access audiences, says Julie Johnson, CHAM, director, revenue cycle management at the Safford, AZ, hospital.
"It started out as a way to address a specific problem at our facility," adds Johnson, but has evolved into a vehicle for inspiring self-awareness and interpersonal understanding in the workplace and beyond.
When initially putting the project together, organizers kept coming back to the theme of "surviving the everyday interactions that occur" and decided to use the motif of the "Survivor" television show in their presentation. They play the soundtrack from the film "Pirates of the Caribbean" to add to the island flavor
Participants at the 2006 National Association of Healthcare Access Management (NAHAM) conference and at the 2007 Association of Illinois Patient Access Managers meeting have said they will use the lessons learned from the program to interact "not only with different departments, but with patients and families," she notes.
Mt. Graham's Survivor team is scheduled to present this summer at Tucson (AZ) Medical Center and at the October 2007 conference of the Healthcare Financial Management Association (HFMA). In addition to Johnson, the team includes Roland Knox, chief operations officer; Candi Garcia, admissions supervisor; Shayse Cope, coder; and Terry Yoo, customer service concierge.
A Survivor exercise that looks at whether people are socializers, executives, lovers or fact-finders — the first letters of which form the acronym "SELF" — provided a wake-up call about the different ways individuals communicate and how those differences can lead to misunderstandings, Johnson says.
The first instruction in that exercise is for extroverts to move toward the front of the room, and introverts to the back, explains Knox.
Then, the fact-finders are told to move to the right, and the "people people" to the left, he adds. The end result is a group of individuals divided into four quadrants according to personality type.
The dawning realization is, for example, that while access personnel are usually socializers or lovers, those in other areas — particularly the "back end" of the hospital — may be fact-finders, Knox notes.
"The people in accounting may call up and say, 'How did you do this?' or 'Why did you miss that?' and the admitter is waiting for, 'Hi, how are you?'"
Johnson recalled overhearing conversations among attendees in which one person turned to the other and, referring to a colleague with whom she'd had a bad experience, said, 'Oh, that's why she acts like that, because she's a [one of the four personality types]."
Those who feel they don't fit neatly into one of the quadrants may choose to stand on a line between two groups during the exercise, Knox notes. "During the last presentation, we ask them, 'Why are you a liner and don't want to go one way or the other?' One gentleman, who was on the line between executive and socializer, essentially said, 'I'm both and I don't have to make a decision. You're not going to put me in one of those boxes.'"
After addressing self-awareness and communication in a couple of activities, Knox says, the team leaders ask their audience to think about six characteristics of a leader, which of those they have, or whether they have any of them:
1. Committed to self-development and lifelong learning.
2. Self-motivated and build on strengths.
3. Able to communicate regularly — up, down and across.
4. Effective in managing work, people, relations, and situations.
5. Realistic and flexible about expectations of self and others.
6. Able to analyze and organize the performance of self and others objectively.
Leaders then pose the question, "Where are you leading your team?" with the suggestion to look at vision, mission, and values, he adds.
Knox, who left a 19-year career in banking after service on the Mt. Graham board of directors sparked a passion to be part of the hospital's day-to-day operations, says he considers health care his "calling."
During his experience presenting the Survivor material, he says, "the No. 1 thing I've learned is that the concepts we share are ones that each person can relate to in his or her own way. When we talk to audience members afterward, they all have a [specific] item they grasped."
The team tells stories that illustrate the different ways people communicate and the misunderstandings that can occur when the entire picture isn't apparent, Knox notes.
One story that many people related to, he adds, is about a man who got on a New York subway with three boys who began running up and down the aisle and generally misbehaving. When a fellow passenger comments that he can't believe the man is allowing his children to be so disruptive, the father, who is in a daze, says, "We just came from the hospital, where their mother just passed away. We don't know how to act."
The complaining passenger changes his whole demeanor at that point, of course, and the clear message of understanding people before you judge them always puts a hush over the audience, Knox adds.
'Salmagundi' caps session
As a crowning touch to the Survivor session, participants are asked to make a "salmagundi" — which he says is something that is "hard to describe, but everything you want it to be" — by building something that is reflective of their group and of what they have learned.
Derived from old English, salmagundi is also the word for a pirate stew that is "basically a conglomeration of whatever is on hand," notes Johnson, so it fits the program theme.
Participants sit in groups at round tables, Knox notes, and at the center of each table is an assortment of such items as play dough, shot glasses, shells, pipe cleaners, and dominoes, among other things.
"As a team, they make a salmagundi," Knox says. "It's amazing. It's quite incredible to see what people can make — a huge island, a zoo, a hospital." The components, he adds, "are the treasures — how to guide others, think about other people before we think about ourselves."
One of the most memorable exercises of the program is "the cup stack," notes Johnson, in which participants must work together as a team to stack 10 paper cups to make a pyramid. The caveat, she explains, is that they can't use any body parts to do it.
Instead, they must use a rubber band and strings to encircle the cup and move it, Johnson says. "They have to decide which cups go where, and if a cup falls down they have to figure out how to pick it up without touching.
"Sometimes natural leaders emerge" during the exercise, she adds. "People say things like, 'Charlene, I didn't know you had it in you,' and she says, 'I saw that nobody was taking the lead and so I did.'"
The Survivor presenters cut their original program from two-and-a-half hours to less than an hour to meet the time constraints of the conferences, Johnson notes. "We had to condense a lot of what we have to say."
The format also was changed to allow for more audience participation, she says. "We wanted there to be a lot of interaction and for everyone to have to get up and move." The idea, she adds, was for the program not to be just "oh, another speaker."
"Even with the cup stack and the salmagundi, they have to get out of their seats, be more creative," Johnson adds. "By stimulating this process that way, they can stimulate the access process, think outside the box to accommodate the patient, and not do everything by the book. They realize they can use their creativity on the job."